| NPI | 1942895867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R206774) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: DC NP2000299) |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2022-11-30 |