| NPI | 1942653688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN01380) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: RI APRN01380) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2020-11-24 |