NPI | 1780340406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2337702) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 701453) |
Enumeration Date | 2021-11-17 |
Last Update Date | 2021-11-17 |