| NPI | 1265903520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: CA 575116) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: CA 575116) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |