| NPI | 1881588309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WI 1689833) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA 95035525) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MN 12976) | |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-10-01 |