| NPI | 1427443944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-131182) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: AL 1-131182) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2023-08-17 |