| NPI | 1336790989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: KY 1065346) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KY 1065346) |
| 163WF0300X Registered Nurse, Flight (Licence: KY 1065346) | |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-27 |