NPI | 1104332469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 799229) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CA 799229) |
Enumeration Date | 2017-12-22 |
Last Update Date | 2017-12-22 |