NPI | 1093953713 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: LA AP04401) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN094539) |
Enumeration Date | 2009-02-03 |
Last Update Date | 2022-12-08 |