| NPI | 1699550848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NC 5019705) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5019705) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2024-03-20 |