| NPI | 1447982475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA GAA-NP000977) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 26215) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2024-01-18 |