| NPI | 1093422107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: CA 95238896) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: CA 95238896) |
| 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: CA 95238896) | |
| 163WE0003X Registered Nurse, Emergency (Licence: CA 95238896) | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-11-05 |