| NPI | 1437884194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NPF95024843) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 95044510) |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2023-08-01 |