NPI | 1902788532 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 39250) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 39250) |
Enumeration Date | 2025-07-24 |
Last Update Date | 2025-09-29 |