| NPI | 1396086807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP23016) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 170480-30) |
| 163W00000X Registered Nurse (Licence: CA RN839435) | |
| 227800000X Respiratory Therapist, Certified (Licence: WI 3298-28) | |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2014-06-09 |