| NPI | 1821186826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN154232) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN154232) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AL 1-092604) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-31 |