| NPI | 1093851743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 514120) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: CA 514120) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-08 |