| NPI | 1548999717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OK 208944) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OK R0121474) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-07-06 |