NPI | 1912791419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9679164) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL 9679164) |
Enumeration Date | 2025-04-08 |
Last Update Date | 2025-04-08 |