| NPI | 1851061956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: FL 11015472) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT 240740) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2024-09-19 |