NPI | 1205283942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9328268) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9328268) |
Enumeration Date | 2016-05-23 |
Last Update Date | 2025-06-03 |