NPI | 1154207454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP95035684) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP95035684) |
363LG0600X Nurse Practitioner, Gerontology (Licence: CA NP95035684) | |
Enumeration Date | 2025-08-12 |
Last Update Date | 2025-08-25 |