| NPI | 1841207560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP14878) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 14878) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CA RN578343) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-03-18 |