NPI | 1871790261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA NPF10113) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN497724) |
Enumeration Date | 2007-06-28 |
Last Update Date | 2007-07-08 |