| NPI | 1619731262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: CT 206165) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: FL 11033985) |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-07-30 |