| NPI | 1710623657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: CA 95281724) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: CA 95281724) |
| 163WM0705X Registered Nurse Medical-Surgical (Licence: AZ 245932) | |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-17 |