| NPI | 1881382836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC F03230328) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NC 303991) |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-05-15 |