NPI | 1245949593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017255) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC PITT-YU2WO) |
Enumeration Date | 2022-11-15 |
Last Update Date | 2024-11-14 |