| NPI | 1437726494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95202641) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 95202641) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-07-01 |