NPI | 1669144770 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 30521) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 209143) |
Enumeration Date | 2021-09-28 |
Last Update Date | 2024-10-18 |