| NPI | 1588195515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000022262) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN266135) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN266135) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN APN0000022262) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-04-12 |