NPI | 1720709967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: AZ 324649) |
Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: AZ RN204990) |
Enumeration Date | 2022-09-07 |
Last Update Date | 2025-07-03 |