| NPI | 1366220295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IA 152550) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IA 152550) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |