| NPI | 1033340799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MD R229482) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: DC RN1041999) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2022-09-23 |