| NPI | 1093475543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA 95018916) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO 1644461) |
| 163W00000X Registered Nurse (Licence: PR 100035) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 723430) | |
| 163W00000X Registered Nurse (Licence: CA 95077925) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-12-25 |
| Last Update Date | 2025-11-20 |