| NPI | 1174529416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP10894) |
| Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: CA RN263075) |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: CA RN263075) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: CA RN263075) | |
| 163WP1700X Registered Nurse, Perinatal (Licence: CA RN263075) | |
| 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: CA RN263075) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP10894) | |
| 363LP1700X Nurse Practitioner, Perinatal (Licence: CA NP10894) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: CA NP10894) | |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: CA 263075) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2023-03-07 |