| NPI | 1144527961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP3259922) |
| Additional Taxonomies | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: FL ARNP3259922) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2016-03-17 |