NPI | 1437849254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11025680) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11025680) |
Enumeration Date | 2023-05-15 |
Last Update Date | 2023-10-10 |