| NPI | 1194250670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: CA 95007809) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: CA 695922) |
| 163WC1500X Registered Nurse Community Health (Licence: CA 71519) | |
| 363L00000X Nurse Practitioner (Licence: CA 95007809) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95007809) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CA 95007809) | |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2021-12-28 |