| NPI | 1336028935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95247980) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95038541) |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2026-03-06 |