NPI | 1003819707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN7641) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN7641) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2024-08-26 |