| NPI | 1437609963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-130679) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO C-APN.0103808-C-NP) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WV 122375) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP61671228) | |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2025-07-21 |