| NPI | 1689049702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AR A005415) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AR A005415) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2024-07-11 |