NPI | 1174343685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 10034043) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OR 10034043) |
Enumeration Date | 2024-10-10 |
Last Update Date | 2024-10-10 |