| NPI | 1437439619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11002927) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-116024) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN225644) | |
| 163W00000X Registered Nurse (Licence: GA RN225644) | |
| 163W00000X Registered Nurse (Licence: AZ RN196428) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP8359) | |
| 363L00000X Nurse Practitioner (Licence: ME CNP231685) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WV 106950) | |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2024-01-25 |