| NPI | 1518588367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11006843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM 71468) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 011624) | |
| 363L00000X Nurse Practitioner (Licence: FL 11006843) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11006843) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: GA NP002317) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 011624) | |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2024-08-28 |