| NPI | 1841478237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 71031) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP009063) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2023-02-01 |