| NPI | 1750025003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN674404) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SC 237735) |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2022-12-20 |