| NPI | 1245076553 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WA AP61577243) | 
| Additional Taxonomies | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: WA AP61577243) | 
| Enumeration Date | 2024-07-05 | 
| Last Update Date | 2024-07-05 |