NPI | 1093738429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001195A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71001195A) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2014-04-01 |