| NPI | 1043518087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0103001-C-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11036718) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 118550) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1175483) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 0035758) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5012797) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 4470) | |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2025-01-29 |