| NPI | 1992157044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MO 2023042392) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP022162) |
| 363L00000X Nurse Practitioner (Licence: CA 95022978) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9481877) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP8837) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 9532) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IN 71014497A) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71014497A) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2024-04-08 |