| NPI | 1477147403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 28087) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TN 244970) |
| Enumeration Date | 2021-02-20 |
| Last Update Date | 2024-03-24 |