| NPI | 1326195652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: CA 1760) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: MN R 095802-6) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-03-07 |