NPI | 1245968973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024185025) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R213897) |
Enumeration Date | 2022-08-10 |
Last Update Date | 2022-11-23 |