| NPI | 1912446337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-132461) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-132461) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: AL 1-132461) | |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: AL 1-132461) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2022-10-07 |