NPI | 1083247951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN277626) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: GA RN277626) |
Enumeration Date | 2020-02-19 |
Last Update Date | 2020-02-19 |