| NPI | 1689865610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN 42517) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA RN 425170) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |