NPI | 1538685961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN9266385) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL ARNP9266385) |
Enumeration Date | 2017-08-17 |
Last Update Date | 2021-05-27 |