NPI | 1689447500 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209028094) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 28240550A) |
363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IN 71014667A) | |
Enumeration Date | 2023-11-02 |
Last Update Date | 2025-08-15 |