| NPI | 1922286400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 1341333092) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KS 1341333092) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |