| NPI | 1851361331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: CA NP13061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 38301) |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: CA RN591568) | |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: TX 607668) | |
| 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: TX 607668) | |
| 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: AK 1505) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-12-01 |