| NPI | 1043648223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LB-0000281) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0034244) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB-0000281) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: DE LB-0000281) | |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2024-10-04 |