NPI | 1629708268 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 859440) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NV 859440) |
363LG0600X Nurse Practitioner, Gerontology (Licence: NV 859440) | |
Enumeration Date | 2022-06-15 |
Last Update Date | 2024-02-21 |