| NPI | 1639450802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: CA 74202) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 731422) | 
| 163WD0400X Registered Nurse, Diabetes Educator (Licence: CA 731422) | |
| 364SC1501X Clinical Nurse Specialist, Community Health/Public Health (Licence: CA 3512) | |
| Enumeration Date | 2011-09-01 | 
| Last Update Date | 2020-06-12 |