| NPI | 1619858644 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 39914) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 229603) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 907878) | |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-12-11 |