| NPI | 1225732845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV F03230702) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NV RN86240) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2025-03-17 |