| NPI | 1750611737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9250368) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL ARNP9250368) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9250368) | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2025-02-07 |