| NPI | 1811348279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN11013400) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IN 71006271A) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2021-10-21 |