| NPI | 1083067144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SR0400X Clinical Nurse Specialist, Rehabilitation (Licence: LA AP09352) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP09352) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: LA AP09352) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2024-05-30 |