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 |