| NPI | 1215706767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 304087) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AZ RN175590) |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2025-02-12 |