| NPI | 1255026357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MD R253533) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: DC RN1061840) |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2024-05-23 |