NPI | 1346912649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DC NP1045161) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: DC 1045161) |
Enumeration Date | 2021-10-04 |
Last Update Date | 2022-03-13 |