| NPI | 1275387383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: NV 883061) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: NV RN57363) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-12-18 |