| NPI | 1215358098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9274236) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 616519) |
| 163W00000X Registered Nurse (Licence: MA rn2284325) | |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |