NPI | 1245518489 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9467571) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 757973) |
Enumeration Date | 2011-07-21 |
Last Update Date | 2017-10-13 |