| NPI | 1346608726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9309582) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9309582) |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |