| NPI | 1770698235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 1616) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 1616) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-07-26 |