| NPI | 1346805769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704327050NSA190BM) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704327050NSA190BM) |
| 363L00000X Nurse Practitioner (Licence: MI 4704327050NSA190BM) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704327050NSA190BM) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MI 4704327050NSA190BM) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704327050NSA190BM) | |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: MI 4704327050NSA190BM) | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2020-01-06 |