| NPI | 1275753873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 699234) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: CA 00020211) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2025-09-11 |