NPI | 1518593847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 201908535NP-PP) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95014504) |
Enumeration Date | 2020-03-18 |
Last Update Date | 2021-04-08 |