| NPI | 1043678436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: PA spo15635) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA spo15635) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: PA spo15635) | |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2024-03-08 |