| NPI | 1093182693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9228302) |
| Additional Taxonomies | 363LX0106X Nurse Practitioner, Occupational Health (Licence: FL ARNP9228302) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2020-02-06 |