NPI | 1467166546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA NP95031072) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60291550) |
Enumeration Date | 2023-01-12 |
Last Update Date | 2024-08-30 |