| NPI | 1427575638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 5010110) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010110) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5010110) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5010110) | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2024-07-15 |