| NPI | 1912382433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 95046278) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95046278) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2023-05-24 |