| NPI | 1861700619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 586721) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: CA 586721) |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 586721) | |
| 171M00000X Case Manager/Care Coordinator (Licence: CA 586721) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2013-07-31 |