| 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 |