| NPI | 1982233383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11006822) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11006822) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL APRN11006822) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2023-04-19 |