| NPI | 1467177618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: GA GAA-NP00157) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: AZ 313157) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2025-06-19 |