NPI | 1851884928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009429) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 790711) |
Enumeration Date | 2018-06-12 |
Last Update Date | 2019-11-21 |