| NPI | 1538753843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11011862) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN1101862) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN1101862) | |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2025-03-14 |