NPI | 1801398086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN275844) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9369160) |
Enumeration Date | 2018-03-05 |
Last Update Date | 2018-03-17 |