| NPI | 1598251498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: CA 95009210) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61493227) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2023-10-20 |