| NPI | 1841253978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 582443) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN38195) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2007-07-08 |