| NPI | 1508525668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AL 1-142269) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-142269) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-142269) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-142269) | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-15 |