| NPI | 1255606190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP121792) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM 57615) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CO C-APN.0002028-C) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 202110735NP-PP) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 817264) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN161177) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AR 217199) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024179434) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61195306) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310749) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 253138) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 16572) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704378488) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H162886) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 12542195-4405) | |
| Enumeration Date | 2012-03-10 |
| Last Update Date | 2024-03-21 |