NPI | 1306452347 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR 124241) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AR 124241) |
363LF0000X Nurse Practitioner, Family (Licence: AR 124241) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: AR 124241) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: AR 124241) | |
Enumeration Date | 2020-09-16 |
Last Update Date | 2023-07-25 |