| NPI | 1184086324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 084900-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP936719) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9367191) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2021-09-23 |