| NPI | 1730959354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: UT 7782242-4405) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: UT 7782242-3102) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-03-19 |