NPI | 1285115451 |
---|---|
Other Name | JOE RUDOLPH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00847400) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00847400) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00847400) | |
Enumeration Date | 2018-08-27 |
Last Update Date | 2019-12-09 |