NPI | 1326557240 |
---|---|
Former Name | JASON ROBERT POWERS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11015460) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2291841) |
163W00000X Registered Nurse (Licence: CA RN95139213) | |
363L00000X Nurse Practitioner (Licence: CA NP95007565) | |
Enumeration Date | 2017-09-22 |
Last Update Date | 2022-06-28 |