| NPI | 1689785842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 286952) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 286952) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-11 |