| NPI | 1447088109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: CA 474909) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 474909) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-08-01 |