NPI | 1609208271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71004544A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004544A) |
Enumeration Date | 2013-08-06 |
Last Update Date | 2025-09-22 |