| NPI | 1437190071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 18985) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 624341) |
| 364S00000X Clinical Nurse Specialist (Licence: CA 3191) | |
| 163WH0200X Registered Nurse, Home Health (Licence: CA 66882) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-03-08 |