NPI | 1780784488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 16861) |
Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: CA 506564) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2022-05-18 |