NPI | 1295402089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: ID 69540) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: ID 45067) |
Enumeration Date | 2021-08-27 |
Last Update Date | 2021-08-30 |