NPI | 1598426389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95019618) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95019618) |
Enumeration Date | 2022-01-04 |
Last Update Date | 2022-01-24 |