NPI | 1386939452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9486122) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN9486122) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2023-08-04 |