| NPI | 1295325785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 836624) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 836624) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NV 836624) | |
| 208600000X Surgery (Licence: NV 836624) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 836624) | |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2024-08-31 |