| NPI | 1497546972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: CA 95062439) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CA 95052439) |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-05-14 |