| NPI | 1497127898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: UT 12497072-4405) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 12497072-4405) |
| Enumeration Date | 2015-10-24 |
| Last Update Date | 2022-03-02 |