NPI | 1922711373 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11023609) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11023609) |
Enumeration Date | 2022-12-30 |
Last Update Date | 2023-01-25 |