NPI | 1952503112 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95016049) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CA 609069) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2020-11-23 |