NPI | 1508544362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA NP95033221) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN264547) |
Enumeration Date | 2023-07-10 |
Last Update Date | 2025-05-12 |