NPI | 1851830558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9297316) |
Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: FL ARNP9297316) |
Enumeration Date | 2017-02-15 |
Last Update Date | 2022-04-13 |