| NPI | 1881275378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MD R218470) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: MD R218470) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-29 |