| 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 |