NPI | 1447892070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MI 4704287329) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MI 4704287329) |
Enumeration Date | 2019-10-15 |
Last Update Date | 2024-01-31 |