| NPI | 1366729766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 21241) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: CA 727706) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2020-11-18 |