| NPI | 1033548854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SD CP001562) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MN 7382) |
| 163W00000X Registered Nurse (Licence: SD R037669) | |
| 363L00000X Nurse Practitioner (Licence: MN 7382) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IA A163231) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: MN 526698) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MN 7382) | |
| 363L00000X Nurse Practitioner (Licence: SD CP001562) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: SD CP001562) | |
| 163W00000X Registered Nurse (Licence: MN R-188311-6) | |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2025-10-06 |