| NPI | 1144900283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-113508) |
| Additional Taxonomies | 163WC3500X Registered Nurse, Cardiac Rehabilitation (Licence: AL 1-113508) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-24 |