| NPI | 1386523199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: CA 95086685) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95086685) |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-08-27 |