| NPI | 1043208598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP980072) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP980072) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: FL ARNP980072) | |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: FL ARNP980072) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2017-03-15 |