| NPI | 1154840676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9418362) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL HSE27055) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 77877) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001006) | |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2023-01-05 |