NPI | 1841694718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP7365) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA GAA-002038) |
Enumeration Date | 2014-10-21 |
Last Update Date | 2025-04-03 |