NPI | 1699558460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: FL APRN11027725) |
Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: FL APRN11027725) |
363LA2200X Nurse Practitioner Adult Health (Licence: FL APRN11027725) | |
Enumeration Date | 2023-08-16 |
Last Update Date | 2023-08-16 |