| NPI | 1932614567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 721060) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 721060) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2025-07-09 |