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 |