| NPI | 1992088702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: AL 1-109674) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: AL 1-109674) |
| 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: TN apn0000016084) | |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2025-10-08 |