| NPI | 1568777415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9485015) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305521) |
| 163WG0000X Registered Nurse, General Practice (Licence: FL 9485015) | |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 533619-1) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: NY 533619-1) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: FL 9485015) | |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2023-02-24 |