NPI | 1427347384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: ID 7071364) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60459728) |
Enumeration Date | 2011-03-31 |
Last Update Date | 2025-05-21 |