| NPI | 1447743943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95009086) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95009086) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2022-03-08 |