| NPI | 1477797793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN 743815) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA 09-0123s) |
| 163WC1500X Registered Nurse, Community Health (Licence: CA PHN 75020) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |