| 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 |