NPI | 1679176051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CO APN.0997291-NP) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 209.022117) |
Enumeration Date | 2020-11-18 |
Last Update Date | 2022-04-27 |