NPI | 1710237425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005802) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 5005802) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5005802) | |
Enumeration Date | 2012-09-11 |
Last Update Date | 2024-07-15 |