| NPI | 1679013197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2100X Clinical Nurse Specialist Acute Care (Licence: CA 3215) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 594174) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |