NPI | 1578003661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9329583) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: FL APRN9329583) |
363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP 9329583) | |
Enumeration Date | 2017-03-08 |
Last Update Date | 2025-01-31 |