| NPI | 1558810309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN9461696) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9461696) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: DE LP-0000348) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R192286) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 008372) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2022-11-10 |