NPI | 1306266655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 823814) |
Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CA 823814) |
Enumeration Date | 2014-04-24 |
Last Update Date | 2019-07-02 |