| NPI | 1447891965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9179205) |
| Additional Taxonomies | 163WI0600X Registered Nurse, Infection Control (Licence: FL APRN9179205) |
| 163WH0200X Registered Nurse, Home Health (Licence: FL APRN9179205) | |
| Enumeration Date | 2019-10-06 |
| Last Update Date | 2019-10-06 |