| NPI | 1932039757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: CA 95199824) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95199824) |
| Enumeration Date | 2026-05-22 |
| Last Update Date | 2026-05-22 |