| NPI | 1205656709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: VA 0001275867) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001275867) |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |