| NPI | 1235765454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: RI APRN02336) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: RI RN57502) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-05-27 |