NPI | 1184479529 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11034469) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9571150) |
Enumeration Date | 2024-04-19 |
Last Update Date | 2024-10-09 |