NPI | 1669893376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017691) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95017691) |
Enumeration Date | 2013-12-23 |
Last Update Date | 2024-10-29 |