| NPI | 1023493913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WN0800X Registered Nurse, Neuroscience (Licence: CA 662207) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 662207) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2019-12-19 |