| NPI | 1972227791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: CA 236289) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95231396) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA 95022040) | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2022-09-27 |