NPI | 1700551355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 432083) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 676793) |
Enumeration Date | 2021-08-14 |
Last Update Date | 2021-08-23 |