NPI | 1003066143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704234332) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4704234332) |
Enumeration Date | 2008-09-25 |
Last Update Date | 2025-07-24 |