NPI | 1417569518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 832691) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV 832691) |
Enumeration Date | 2020-08-19 |
Last Update Date | 2024-05-16 |