| NPI | 1174865034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: CA 579098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 579098) |
| 163WC0400X Registered Nurse, Case Management (Licence: CA 579098) | |
| 163WH0200X Registered Nurse, Home Health (Licence: CA 579098) | |
| 163WH1000X Registered Nurse, Hospice (Licence: CA 579098) | |
| 163WS0200X Registered Nurse, School (Licence: CA 579098) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: CA 579098) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |