NPI | 1578382917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2371801) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2371801) |
Enumeration Date | 2024-10-03 |
Last Update Date | 2024-10-08 |