NPI | 1831433358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP022985) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP022985) |
Enumeration Date | 2012-11-21 |
Last Update Date | 2020-12-31 |