NPI | 1538652979 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9322999) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: FL 9322999ARNP) |
363L00000X Nurse Practitioner (Licence: FL 9322999ARNP) | |
Enumeration Date | 2018-06-11 |
Last Update Date | 2025-08-25 |