| NPI | 1427718949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NH 086230-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 086230-21) |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2026-02-26 |