| NPI | 1437386695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: KS 44702) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MO 072720) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |