| NPI | 1316546716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-2890) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-85614) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2022-07-12 |