NPI | 1245337872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95020519) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA dc25160) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95020519) | |
Enumeration Date | 2006-09-17 |
Last Update Date | 2024-07-21 |