NPI | 1013001544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R850364) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R850364) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2013-04-24 |