| NPI | 1952849481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 846513) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: CA 846513) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |