| NPI | 1861892135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 500425) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 500425) |
| Enumeration Date | 2014-08-24 |
| Last Update Date | 2014-08-24 |