| NPI | 1396499323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: DC NP200004425) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001265799) |
| 163W00000X Registered Nurse (Licence: DC RN200004425) | |
| 363LA2100X Nurse Practitioner Acute Care (Licence: VA 0024189949) | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2024-04-30 |