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 |