| NPI | 1154092781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11039938) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-166795) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AL 1-1667795) | |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2025-11-18 |