NPI | 1487876421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MD AC000874) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: LA RN109429AP04458) |
363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024166790) | |
Enumeration Date | 2007-05-02 |
Last Update Date | 2017-07-20 |