| NPI | 1407306681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95004640) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: CA NP95004640) |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: CA NP95004640) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2025-05-06 |