NPI | 1194081588 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MD R193426) |
Additional Taxonomies | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: MD CS00100) |
Enumeration Date | 2012-04-10 |
Last Update Date | 2020-10-14 |