| NPI | 1003157348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 1051787) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 646009) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: VA 1173394) | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2024-07-23 |