| NPI | 1437998523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-029630) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: IL 209-029630) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-07-02 |