NPI | 1528727989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2329252) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MA RN2329252) |
Enumeration Date | 2021-12-14 |
Last Update Date | 2024-01-29 |