| NPI | 1326014283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN568034) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT-002053-A) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2025-09-11 |