NPI | 1639435456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 786160) |
Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CA 786160) |
Enumeration Date | 2012-04-05 |
Last Update Date | 2017-10-13 |