NPI | 1306436944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11013757) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN11013757) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-01-18 |
Last Update Date | 2024-09-24 |