| NPI | 1881378925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: CA 4650) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 694189) |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2023-06-09 |