NPI | 1215358288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024171263) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024171263) |
Enumeration Date | 2013-12-18 |
Last Update Date | 2024-01-16 |