| NPI | 1588781959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA RN387281) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NPF11216) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CA NPF11216) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-08 |