| NPI | 1083112494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-143381) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AL 1-143381) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2025-01-02 |