| NPI | 1073322392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: CA 283866) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 283866) |
| Enumeration Date | 2025-01-01 |
| Last Update Date | 2025-01-01 |