| NPI | 1144844184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 202005325NP-PP) |
| Additional Taxonomies | 163WF0300X Registered Nurse, Flight (Licence: OR 200942580RN) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2023-01-26 |