NPI | 1093488231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN192874) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ 262007) |
Enumeration Date | 2021-07-25 |
Last Update Date | 2024-07-28 |