| NPI | 1952441693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: UT 2172004485) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: AZ AP8069) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2025-06-30 |