NPI | 1174561468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201150165NP) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WA AP30006102) |
363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP30006102) | |
Enumeration Date | 2006-06-02 |
Last Update Date | 2023-03-07 |