| NPI | 1235376682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: FL APRN1851212) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: FL ARNP 2682012) |
| 163WN0800X Registered Nurse Neuroscience (Licence: FL ARNP2682012) | |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2019-10-16 |