| NPI | 1144773383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP016592) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: PA RN602929) |
| Enumeration Date | 2016-07-24 |
| Last Update Date | 2016-11-02 |