NPI | 1528598570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: HI 2844) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 22743) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2023-05-31 |