| NPI | 1437215027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN401356) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA RN401356) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2016-01-08 |