NPI | 1447794383 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP017015) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP017015) |
Enumeration Date | 2016-12-12 |
Last Update Date | 2020-08-31 |