NPI | 1568892552 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9314833) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9314833) |
363LG0600X Nurse Practitioner, Gerontology (Licence: FL 9314833) | |
Enumeration Date | 2013-11-12 |
Last Update Date | 2020-04-17 |