| NPI | 1023401882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CA 748137) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 748137) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2023-04-09 |