NPI | 1275893968 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201702166NP-PP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP-01988) |
364SA2100X Clinical Nurse Specialist, Acute Care (Licence: NM CNP-01988) | |
Enumeration Date | 2012-05-29 |
Last Update Date | 2022-12-06 |