| NPI | 1982854253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 17774) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 607871) |
| 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: CA 2830) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |