| NPI | 1265205108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NM RN-80349) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: NM RN-80349) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |