| NPI | 1497951693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: CA 550359) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CA 550359) |
| 163WX0200X Registered Nurse, Oncology (Licence: CA 550359) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2025-09-11 |