| NPI | 1194470674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 835027) |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-02-14 |