NPI | 1720630197 |
---|---|
Other Name | JIM STALIANS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95010123) |
Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: CA 452145) |
363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95010123) | |
Enumeration Date | 2019-07-15 |
Last Update Date | 2019-07-15 |