NPI | 1689782831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP17701) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN711690) |
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA NP17701) | |
Enumeration Date | 2006-08-28 |
Last Update Date | 2019-12-18 |