NPI | 1467903385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95013625) |
Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: CA 758854) |
Enumeration Date | 2016-10-14 |
Last Update Date | 2020-08-31 |