| NPI | 1417182114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NC 204087) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-107032) |
| 163W00000X Registered Nurse (Licence: MA RN2263247) | |
| 163W00000X Registered Nurse (Licence: NY 708860) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 740710) | |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2023-09-07 |