| NPI | 1013552199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: FL APRN11004781) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: MN 2166722) |
| 364SA2200X Clinical Nurse Specialist Adult Health (Licence: MN 524) | |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |