| NPI | 1023538139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP134227) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704395712) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 248267) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AR 220021) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: ID 65923) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71013102A) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3018335) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: LA 223728) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 905140) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NV 847896) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NM 56805) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61137506) | |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IA H171191) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-12-02 |