NPI | 1023884319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95026204) |
Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CA 5077) |
Enumeration Date | 2023-11-28 |
Last Update Date | 2024-06-03 |