NPI | 1952775199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9311770) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9311770) |
363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9311770) | |
Enumeration Date | 2015-11-28 |
Last Update Date | 2015-12-02 |