| NPI | 1518893247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95246959) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: CA 2005469512) |
| Enumeration Date | 2026-06-22 |
| Last Update Date | 2026-06-29 |