| NPI | 1497005268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 784345) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 785345) |
| 163WP0000X Registered Nurse, Pain Management (Licence: CA 95000245) | |
| 363L00000X Nurse Practitioner (Licence: CA 95000245) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2025-08-25 |