| NPI | 1245474998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 867664) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS R867664) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2024-08-30 |