| NPI | 1245865104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IL 209021644) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 128262) |
| 163W00000X Registered Nurse (Licence: IL 041409388) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IA H159862) | |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2023-11-14 |