NPI | 1184195083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11000603) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: FL APRN11000603) |
Enumeration Date | 2018-12-17 |
Last Update Date | 2024-05-17 |