| NPI | 1376311480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: UT 904352-4405) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: UT 11588995-3102) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2024-03-15 |