NPI | 1659055309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11026912) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11026912) |
Enumeration Date | 2023-06-13 |
Last Update Date | 2025-10-06 |