| NPI | 1851969380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11013931) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9398946) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NH 090006-23) | |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2023-04-26 |