| NPI | 1619213824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: TN 127146) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN RN0000127146) |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2025-07-23 |