NPI | 1750091666 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP61382758) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP61382758) |
Enumeration Date | 2022-12-01 |
Last Update Date | 2022-12-01 |