| NPI | 1336856798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376G00000X Nursing Home Administrator (Licence: CA RCFE) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN185528) |
| 376G00000X Nursing Home Administrator | |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-03 |