| NPI | 1760810857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN206831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA RN206831) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA RN206831) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA RN206831) | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2024-11-05 |