| NPI | 1972745859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 597838) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 597838) |
| 163WC0400X Registered Nurse, Case Management (Licence: CA 597838) | |
| 163WR0400X Registered Nurse, Rehabilitation (Licence: CA 597838) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |