NPI | 1023467321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 655291-1) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 655291-1) |
Enumeration Date | 2016-06-07 |
Last Update Date | 2023-06-05 |