| NPI | 1609272665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 830919) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: CO 1629622) |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: KS 13-113736-012) | |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: MA RN2292709) | |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: WA RN60379787) | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |