| NPI | 1538886916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN316226) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: GA RN316226) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2024-12-19 |