NPI | 1841919495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025759) |
Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: IL 041359029) |
363LA2100X Nurse Practitioner Acute Care (Licence: IL 209025759) | |
Enumeration Date | 2022-08-25 |
Last Update Date | 2023-01-30 |