NPI | 1902461601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MN 6693) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 6693) |
Enumeration Date | 2019-05-08 |
Last Update Date | 2024-06-19 |