NPI | 1447666086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN3361362) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN3361362) |
Enumeration Date | 2014-07-03 |
Last Update Date | 2025-07-24 |