| NPI | 1982180378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN2970412) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN95113212) |
| 163W00000X Registered Nurse (Licence: WA RN60682202) | |
| 163W00000X Registered Nurse (Licence: MN 239908-1) | |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |