NPI | 1679210538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NV 849173) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NV 849173) |
Enumeration Date | 2022-05-12 |
Last Update Date | 2022-09-15 |