| NPI | 1194238808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002750) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV APRN002750) |
| 363LF0000X Nurse Practitioner, Family (Licence: NV TAPRN701731) | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2022-10-19 |