| NPI | 1972964252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: CA 571801) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CA 571801) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |