NPI | 1003326836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 36205) |
Additional Taxonomies | 183700000X Pharmacy Technician (Licence: TN 60924) |
163W00000X Registered Nurse (Licence: TN RN210886) | |
Enumeration Date | 2017-10-06 |
Last Update Date | 2024-05-01 |