| NPI | 1437612538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: NV 839048) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: CA 95011464) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: NV 839048) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95011464) | |
| 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: CA 95011464) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NV 839048) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NV 839048) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CA 95011464) | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2022-10-13 |