NPI | 1184825150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN APN11414) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN11414) |
Enumeration Date | 2007-05-29 |
Last Update Date | 2025-06-09 |