NPI | 1669454872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP 14943) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA RN 508036) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2009-02-27 |