NPI | 1508591132 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: TX 1002145) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1002145) |
Enumeration Date | 2022-07-18 |
Last Update Date | 2022-11-28 |