NPI | 1538753843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11011862) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9336107) |
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 | 2021-10-24 |