| NPI | 1063446516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: AR A005607) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP9302) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-08-13 |