NPI | 1184988081 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NV APN001383) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NV APN001383) |
Enumeration Date | 2012-06-26 |
Last Update Date | 2012-06-26 |