| NPI | 1841839107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 201911193NP-PP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61307074) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WA AP61307074) | |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2022-08-22 |