| NPI | 1043077340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CA 95246336) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: AZ 284601) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2025-09-04 |