NPI | 1851786354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95145633) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2015-04-01 |
Last Update Date | 2021-02-13 |