| NPI | 1275996639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 24799) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9282649) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 24799) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL ARNP 9282649) | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2018-12-27 |