NPI | 1215161526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NH 037311-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0053103) |
Enumeration Date | 2009-05-14 |
Last Update Date | 2015-12-15 |