NPI | 1619687167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024184925) |
Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0024184925) |
Enumeration Date | 2022-11-23 |
Last Update Date | 2024-02-22 |