NPI | 1679343081 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 29026) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: SC 29026) |
Enumeration Date | 2024-01-05 |
Last Update Date | 2024-08-23 |