NPI | 1184335085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 287253) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 287253) |
Enumeration Date | 2022-12-12 |
Last Update Date | 2025-09-04 |