| NPI | 1992288278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9453440) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL APRN9453440) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2024-01-08 |