| NPI | 1437424983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP7817) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN110209) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2023-02-02 |