| NPI | 1518635283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: AZ 248031) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AZ 248031) |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2025-03-18 |