NPI | 1033506498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APRN001948) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95002022) |
163W00000X Registered Nurse (Licence: NV RN82977) | |
Enumeration Date | 2015-04-22 |
Last Update Date | 2016-11-08 |