| NPI | 1932439767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP19434) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 556344) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2024-04-16 |