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 |