| NPI | 1427715176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95022416) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: GA RN210393) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: GA RN210393) | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2022-12-02 |