NPI | 1639967490 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 323282) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ RN209649) |
Enumeration Date | 2025-04-30 |
Last Update Date | 2025-05-07 |