NPI | 1538803952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY F432410) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 725481) |
Enumeration Date | 2022-04-21 |
Last Update Date | 2023-05-29 |