| NPI | 1679790679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 575703) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: CA 575703) |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 575703) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: CA 575703) | |
| 251B00000X Case Management (Licence: CA 575703) | |
| 251K00000X Public Health or Welfare (Licence: CA 575703) | |
| 261QC1500X Clinic/Center, Community Health (Licence: CA 575703) | |
| 261QP0905X Clinic/Center, Public Health, State or Local (Licence: CA 575703) | |
| 281PC2000X Chronic Disease Hospital, Children (Licence: CA 575703) | |
| 282NC2000X General Acute Care Hospital, Children (Licence: CA 575703) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |