NPI | 1295176410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: UT 6820738-8900) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: UT 6820738-4405) |
Enumeration Date | 2013-07-16 |
Last Update Date | 2013-08-19 |