| NPI | 1144899147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN307084) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN307084) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 231688) | |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-10-13 |