| NPI | 1194675215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: CA 95264421) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95264421) |
| Enumeration Date | 2026-01-29 |
| Last Update Date | 2026-01-29 |