| NPI | 1184027724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95000121) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95000121) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 89303287) | |
| 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 4194) | |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2020-12-18 |