| NPI | 1013597756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 842849) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NV RN97847) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-09-17 |