NPI | 1841849643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024183677) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11003325) |
Enumeration Date | 2019-09-05 |
Last Update Date | 2025-03-17 |