NPI | 1366498800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP1826862) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP1826862) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2010-08-02 |