| NPI | 1386236321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN03117) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: RI RN50558) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2024-07-01 |