| NPI | 1689447500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: IN 71014667A) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: IN 28240550A) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-27 |