NPI | 1982700134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 7717) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN APN7717) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2023-06-21 |