| NPI | 1144560616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: CA 737951) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 737951) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |