| NPI | 1942031216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse Critical Care Medicine (Licence: GA RN278989) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: NY 800391) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-09 |