| NPI | 1083475198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN782079) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN295055) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-17 |