| NPI | 1942885298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R196970) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MD R196970) |
| 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: MD CS00172) | |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2026-07-10 |