| NPI | 1598399677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 235165) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: AZ RN193635) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: AZ 235165) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 235165) | |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2022-03-18 |