NPI | 1760905780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP61051870) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61051870) |
Enumeration Date | 2017-07-21 |
Last Update Date | 2020-05-05 |