NPI | 1972110922 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NV 843279) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV 843279) |
Enumeration Date | 2020-09-24 |
Last Update Date | 2024-10-30 |