| NPI | 1083957393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: CA 22964) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 22964) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-04-04 |