NPI | 1053185256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NJ 26NJ15000900) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR22665200) |
Enumeration Date | 2023-11-08 |
Last Update Date | 2024-10-15 |