| NPI | 1194217182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN95117571) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA RN95117571) |
| 163WX0800X Registered Nurse, Orthopedic (Licence: CA RN95117571) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |