NPI | 1164233060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NJ 26NJ15244200) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR18209600) |
364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: NJ 26NJ15244200) | |
Enumeration Date | 2025-01-20 |
Last Update Date | 2025-01-20 |