NPI | 1669800843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5008614) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 18552) |
Enumeration Date | 2013-10-24 |
Last Update Date | 2023-05-15 |