| NPI | 1487190492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: CA 783570) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 785570) |
| 163WX1500X Registered Nurse, Ostomy Care (Licence: CA 783570) | |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-24 |