NPI | 1891459400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP024662) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP024662) |
Enumeration Date | 2021-10-29 |
Last Update Date | 2022-01-17 |