NPI | 1770937294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71006307A) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71006307A) |
Enumeration Date | 2016-04-21 |
Last Update Date | 2022-07-21 |