| NPI | 1437380938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA 280075) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN280075) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2024-09-25 |