| NPI | 1396312930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 767152) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 767152) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2024-09-30 |