| NPI | 1740156421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95108787) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95108787) |
| 163WA2000X Registered Nurse, Administrator (Licence: CA a7006495) | |
| 163WE0003X Registered Nurse, Emergency (Licence: CA 95108787) | |
| Enumeration Date | 2025-10-11 |
| Last Update Date | 2025-10-11 |