| NPI | 1417539107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 408587) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: CA 1385) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-04-23 |