| NPI | 1295983831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 3104878-4405) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: UT 3104878-4405) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2023-03-02 |