| NPI | 1730648023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: MN 578) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MN R-173029) |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2021-09-17 |