| NPI | 1386441038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: CA 576072) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: CA 71751) |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-02-28 |