NPI | 1356658785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9276678) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9276678) |
Enumeration Date | 2010-09-07 |
Last Update Date | 2022-06-13 |