| NPI | 1285407676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: RI APRN03694) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: RI APRN03694) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-12-22 |