NPI | 1033781760 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 715724) |
Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 715721) |
Enumeration Date | 2021-07-13 |
Last Update Date | 2023-05-08 |