NPI | 1336689900 |
---|---|
Former Name | LEIGH CARBUTT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009290) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5009290) |
Enumeration Date | 2017-03-02 |
Last Update Date | 2023-11-28 |