NPI | 1477054617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN9316154) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9316154) |
Enumeration Date | 2018-02-22 |
Last Update Date | 2021-03-29 |