| NPI | 1023293073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 334045) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 334045) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |