NPI | 1215352109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 95000032) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95000032) |
Enumeration Date | 2014-02-28 |
Last Update Date | 2023-07-11 |