| NPI | 1588470645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 111111111111111) |
| Additional Taxonomies | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 11111111111) |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |