| NPI | 1033651195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95005542) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 753430) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2022-07-21 |