| NPI | 1184255952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: UT 9257631-4405) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: UT 9257631-3102) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2024-10-23 |