| 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 | 2007-07-08 |