| NPI | 1932997566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 887676) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NV 887676) |
| 363L00000X Nurse Practitioner (Licence: AZ 326120) | |
| Enumeration Date | 2025-04-25 |
| Last Update Date | 2026-07-31 |