| NPI | 1780890194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: CA 564081) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 564081) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2024-10-23 |