| NPI | 1700652831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse Critical Care Medicine (Licence: NC 286583) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: NC 286583) |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |