| NPI | 1841937026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP61496483) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 853064) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2023-11-28 |