| NPI | 1598041261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21334) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 707882) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2023-01-25 |