| NPI | 1447287917 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA RN546728)  | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA NPF11973)  | 
| Enumeration Date | 2006-06-28 | 
| Last Update Date | 2025-09-11 |