| NPI | 1306031232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: HI 50652) |
| Additional Taxonomies | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 2000643163) |
| 163WG0600X Registered Nurse, Gerontology (Licence: MD 20200099687) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2025-11-20 |