NPI | 1295292019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LP-0000234) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: DE LP-0000234) |
Enumeration Date | 2019-02-28 |
Last Update Date | 2024-10-28 |