NPI | 1487011557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9333526) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9333526) |
Enumeration Date | 2016-01-20 |
Last Update Date | 2018-10-02 |