| NPI | 1871732024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: FL ARNP 2578352) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2578352) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2024-03-11 |