| NPI | 1578327888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: CA 5110) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95181782) |
| 163WM0705X Registered Nurse Medical-Surgical (Licence: CA 95181782) | |
| 163WX0200X Registered Nurse Oncology (Licence: CA 95181782) | |
| 364SA2200X Clinical Nurse Specialist Adult Health (Licence: CA 5110) | |
| 364SG0600X Clinical Nurse Specialist Gerontology (Licence: CA 5110) | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |