| NPI | 1376259242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 0000258461) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000258461) |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-10-26 |