| NPI | 1336722784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN63676) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: PA RN63676) |
| 163WG0100X Registered Nurse, Gastroenterology (Licence: PA RN63676) | |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: PA RN63676) | |
| 163WU0100X Registered Nurse, Urology (Licence: PA RN63676) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |