| NPI | 1821099920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5005373) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN 110922) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN APN0000007433) | |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TN APN 7433) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5005373) | |
| 163W00000X Registered Nurse (Licence: NC 257731) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2014-04-16 |