| NPI | 1194799098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN1955242) |
| Additional Taxonomies | 364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: FL APRN1955242) |
| 364S00000X Clinical Nurse Specialist (Licence: FL APRN1955242) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-08-05 |