| NPI | 1215827761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 089127-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 089127-23) |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2026-04-10 |