| NPI | 1902518376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ 274765) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AZ 274765) |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2024-09-18 |