| NPI | 1609496801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R190493) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD R190493) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MD R190493) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95009008) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA 95009008) | |
| 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: CA 4513) | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2023-03-10 |