| NPI | 1427776269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 858600) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 858600) |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2022-10-25 |