| NPI | 1427783141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN95267723) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95267723) |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2022-07-18 |