| NPI | 1407334543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 3513) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95010692) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2019-06-11 |