NPI | 1538281225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001936) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 763379) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2024-05-29 |