NPI | 1679739486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9175726) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 069086-23) |
163WE0003X Registered Nurse, Emergency (Licence: NH 069086-21) | |
Enumeration Date | 2008-07-31 |
Last Update Date | 2016-04-02 |