| NPI | 1558643999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IN 71005016A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008904) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2024-01-12 |