NPI | 1538840079 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024187668) |
Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0024187668) |
Enumeration Date | 2023-07-27 |
Last Update Date | 2024-10-08 |