NPI | 1144363342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024169483) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: DC RN967155) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2020-12-14 |