| NPI | 1689126963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: CA RN763451) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: CA 10221411) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |