| NPI | 1821358151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse Emergency (Licence: CA 95172563) |
| Additional Taxonomies | 104100000X Social Worker |
| 163W00000X Registered Nurse (Licence: CA 95172563) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-03-28 |