| NPI | 1134520018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV aprn002618) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NV RN60561) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2018-06-26 |