| NPI | 1205632189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MS 918758) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 907719) |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-10-03 |