NPI | 1427735570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 4009283) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KY 1142734) |
Enumeration Date | 2023-06-30 |
Last Update Date | 2023-09-07 |