| NPI | 1255145579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN11037652) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9531095) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11037652) | |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-04-30 |