| NPI | 1285094433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: GA RN190757) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: DE LM-0000137) |
| 363L00000X Nurse Practitioner (Licence: DE LM-0000137) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2025-09-25 |