NPI | 1609581537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11027964) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN11027964) |
Enumeration Date | 2023-01-16 |
Last Update Date | 2024-01-11 |