| NPI | 1326285636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9387899) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9387899) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9387899) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9387899) | |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2024-08-07 |