| NPI | 1437558913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2288790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN53494) |
| 163W00000X Registered Nurse (Licence: MA RN2288790) | |
| 363L00000X Nurse Practitioner (Licence: MA RN2288790) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: RI APRN01153) | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2022-10-31 |