NPI | 1346991767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: GA RN279827) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN279827) |
Enumeration Date | 2022-01-17 |
Last Update Date | 2024-05-20 |