NPI | 1013771203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA 95029023) |
Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA 95029023) |
363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95029023) | |
Enumeration Date | 2024-02-08 |
Last Update Date | 2024-02-08 |