| NPI | 1992985766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: OR 079042382RN) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OR 079042382RN) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2007-11-09 |