| NPI | 1841071693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029156) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL 11029156) |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2025-04-15 |