NPI | 1750909008 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AZ 244057) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 244057) |
363LA2100X Nurse Practitioner Acute Care (Licence: AZ 244057) | |
363LG0600X Nurse Practitioner Gerontology (Licence: AZ 244057) | |
Enumeration Date | 2020-07-13 |
Last Update Date | 2024-02-02 |