| NPI | 1013354489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: AZ AP8087) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: AZ RN111478) |
| Enumeration Date | 2013-05-26 |
| Last Update Date | 2019-04-24 |