| NPI | 1821829755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 10033278) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: OR 201140201) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-10-02 |