NPI | 1326449117 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11031684) |
Additional Taxonomies | 364SE0003X Clinical Nurse Specialist, Emergency (Licence: VA 0001250803) |
Enumeration Date | 2014-09-11 |
Last Update Date | 2025-07-08 |