NPI | 1881275477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 085918-23) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NH 085918-23) |
363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2315152) | |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2315152) | |
Enumeration Date | 2021-04-15 |
Last Update Date | 2021-10-11 |