| NPI | 1629100656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NPF14209) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA RN569767) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2008-07-21 |