| NPI | 1033427927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 794827) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 237194) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2013-08-13 |