| NPI | 1255994588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: AL 1-149801) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: AL 1-149801) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2023-06-29 |