| NPI | 1578248233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA GAA-NP001479) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 289189) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-06-20 |