NPI | 1437740123 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11011305) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11011305) |
Enumeration Date | 2021-01-27 |
Last Update Date | 2024-02-05 |