NPI | 1457758906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95000495) |
Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: CA 95000495) |
Enumeration Date | 2014-11-28 |
Last Update Date | 2024-02-13 |