| NPI | 1245666536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A003929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR A003929) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2024-04-22 |