NPI | 1760922322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 20637) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 20637) |
Enumeration Date | 2017-03-02 |
Last Update Date | 2019-05-21 |