| 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 |