NPI | 1225155690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: CA RN568106) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA NPF13458) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2007-07-08 |