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 |