| NPI | 1609328020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA RN521611L) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN521611L) |
| 163WF0300X Registered Nurse, Flight (Licence: PA RN521611L) | |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |