NPI | 1871133686 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 342657) |
Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: NY 670426) |
363LA2100X Nurse Practitioner Acute Care (Licence: NY 431683) | |
Enumeration Date | 2020-01-09 |
Last Update Date | 2021-05-25 |