| NPI | 1356753198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 784990) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: CA 13461) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |