NPI | 1164182473 |
---|---|
Former Name | ADRIAN ALEXIS DIAZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 67058) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NM 67058) |
363LF0000X Nurse Practitioner, Family (Licence: CO 0997231) | |
Enumeration Date | 2021-12-28 |
Last Update Date | 2023-12-18 |