| NPI | 1689151003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AR R107274) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R107274) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-31 |