| NPI | 1639287592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: SC 1848) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: SC 1848) |
| 363L00000X Nurse Practitioner (Licence: SC 1848) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-10-28 |