NPI | 1134460942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 24754) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 24754) |
Enumeration Date | 2013-03-05 |
Last Update Date | 2023-06-21 |