NPI | 1750520284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R866350) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS R866350) |
Enumeration Date | 2009-02-05 |
Last Update Date | 2015-06-18 |