| NPI | 1104434059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL 9534880) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL 9534880) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |