| NPI | 1831070580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: TX 2026073666) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 1125491) |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2026-08-04 |