NPI | 1417504887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: LA 203735) |
Additional Taxonomies | 208600000X Surgery (Licence: LA 203735) |
363LF0000X Nurse Practitioner, Family (Licence: LA 203735) | |
Enumeration Date | 2019-08-21 |
Last Update Date | 2024-08-18 |