NPI | 1346760022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95009612) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 722006) |
163W00000X Registered Nurse (Licence: CA 95126034) | |
Enumeration Date | 2017-06-22 |
Last Update Date | 2024-07-09 |