| 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 |