| NPI | 1275375271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OK 218482) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0119982) |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-18 |