| NPI | 1679263271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 839439) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NV 839439) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NV 839439) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NV 839439) | |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2026-02-19 |