NPI | 1861029159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: ID NP-75863) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 202000267NP-PP) |
Enumeration Date | 2020-03-25 |
Last Update Date | 2024-02-29 |