NPI | 1720688443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: AZ 249498) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 249498) |
Enumeration Date | 2020-10-30 |
Last Update Date | 2021-11-30 |