| NPI | 1669526752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 481568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 16458) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2024-05-07 |