| NPI | 1588020010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9295984) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9295984) |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: FL ARNP9295984) | |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-25 |