| NPI | 1790677714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse Critical Care Medicine (Licence: CA 95192399) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: TX 846701) |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |