NPI | 1891570453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704268806) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704268806) |
Enumeration Date | 2023-08-30 |
Last Update Date | 2025-04-15 |