| NPI | 1285024083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95002040) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95002040) |
| 163WG0600X Registered Nurse, Gerontology (Licence: NV 822775) | |
| 363L00000X Nurse Practitioner (Licence: CA 95002040) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NV 822775) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NV 822775) | |
| 163W00000X Registered Nurse (Licence: CA 715867) | |
| Enumeration Date | 2015-01-31 |
| Last Update Date | 2023-05-17 |