NPI | 1194200626 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9434275) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN9434275) |
Enumeration Date | 2018-10-01 |
Last Update Date | 2025-09-25 |