NPI | 1265262752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: CA 742905) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95032046) |
Enumeration Date | 2024-08-07 |
Last Update Date | 2024-10-16 |