| NPI | 1194941302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: CA 529574) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 529574) |
| 163WA2000X Registered Nurse, Administrator (Licence: CA 529574) | |
| 163WC0400X Registered Nurse, Case Management (Licence: CA 529574) | |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 529574) | |
| 163WE0003X Registered Nurse, Emergency (Licence: CA 529574) | |
| 163WX0106X Registered Nurse, Occupational Health (Licence: CA 529574) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-09-11 |