NPI | 1194432039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 812303) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV 812303) |
Enumeration Date | 2022-10-31 |
Last Update Date | 2023-09-15 |