NPI | 1871852756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11022927) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R166238) |
Enumeration Date | 2012-05-11 |
Last Update Date | 2025-10-08 |