NPI | 1932106697 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 349032) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30004493) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2007-07-22 |