| NPI | 1588091540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse Critical Care Medicine (Licence: GA RN211348) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: GA RN211348) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2024-05-16 |