| NPI | 1487939989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP20891) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 20891) |
| 364SF0001X Clinical Nurse Specialist, Family Health (Licence: CA 20891) | |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2015-02-26 |