| NPI | 1891512075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP030973) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN623490) |
| 163WF0300X Registered Nurse, Flight (Licence: MD R211119) | |
| 163WF0300X Registered Nurse, Flight (Licence: PA RN623490) | |
| 163WF0300X Registered Nurse, Flight (Licence: DE L1-0045059) | |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2025-01-10 |