| NPI | 1588327431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: FL 11016043) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11016043) |
| 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: FL 11016043) | |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2024-03-25 |