NPI | 1205224870 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A004285) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR ATP000731) |
Enumeration Date | 2015-01-05 |
Last Update Date | 2022-12-07 |