| NPI | 1992044259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN159319) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 618762) |
| 163W00000X Registered Nurse (Licence: CA 688164) | |
| 163W00000X Registered Nurse (Licence: IL 041287209) | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |