NPI | 1306509971 |
---|---|
Former Name | ROBERT MARK MAXILOM POLINTAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 860179) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1099927) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP024314) | |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01261800) | |
363LF0000X Nurse Practitioner, Family (Licence: NY 349083) | |
Enumeration Date | 2021-10-20 |
Last Update Date | 2023-10-31 |