| NPI | 1841820099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 68193) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM 68193) |
| 163W00000X Registered Nurse (Licence: CA 95191512) | |
| 364S00000X Clinical Nurse Specialist (Licence: NM 68193) | |
| 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: TX 1180827) | |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2025-11-06 |