| NPI | 1932814951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN11026962) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11026962) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2025-02-17 |