| NPI | 1912892191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: CA 464108) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 464108) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 464108) | |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 464108) | |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-10 |