NPI | 1891940839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 930163) |
Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: NC 930163) |
Enumeration Date | 2008-11-18 |
Last Update Date | 2024-07-25 |