| NPI | 1831644350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 901824) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MS 904584) |
| 163W00000X Registered Nurse (Licence: MS 904584) | |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-11-18 |