NPI | 1871092254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95008560) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 95008560) |
Enumeration Date | 2018-02-12 |
Last Update Date | 2022-04-22 |