NPI | 1982007340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: DC 1034720) |
Enumeration Date | 2014-09-30 |
Last Update Date | 2022-04-26 |