| NPI | 1033248471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 740992) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 219354) |
| 163WC0400X Registered Nurse, Case Management (Licence: CA 740992) | |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2009-09-14 |