| NPI | 1255199907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: ND R46122) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: ND R46122) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-11-03 |