NPI | 1093725673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 12115) |
Additional Taxonomies | 364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: TN 12115) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2025-07-22 |