| NPI | 1437441524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 778311) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 778311) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95005886) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 778311) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 778311) | |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2023-10-13 |