| NPI | 1679360069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MD AC008529) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: DE LM-0010203) |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: DE L1-0075402) | |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2026-03-04 |