NPI | 1265804876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: FL ARNP9422486) |
Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: FL ARNP9422486) |
Enumeration Date | 2015-10-22 |
Last Update Date | 2018-02-16 |