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 |