NPI | 1164766648 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 22534) |
Additional Taxonomies | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: CA 3889) |
Enumeration Date | 2012-11-21 |
Last Update Date | 2023-11-27 |