| NPI | 1366741944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 4091) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 711310) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2021-12-06 |