| NPI | 1982864237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 99023876A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1075837) |
| 163W00000X Registered Nurse (Licence: FL RN 9243280) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |