NPI | 1952847733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011036) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3011036) |
Enumeration Date | 2017-01-17 |
Last Update Date | 2018-02-20 |