| NPI | 1487714366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse Administrator (Licence: CA 509972) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: CA 509972) |
| 163WC1500X Registered Nurse Community Health (Licence: CA 64734) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 509972) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2009-07-23 |