| NPI | 1699537126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95324446) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: CA 95324446) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-01-30 |