| NPI | 1023896453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: NY 002361) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: CA CNM08922) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2026-01-07 |