| NPI | 1851886915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9368299) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9368299) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2023-12-07 |