| NPI | 1326889734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5020457) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NC 291241) |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-07-23 |