NPI | 1346633039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP10358) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95002184) |
Enumeration Date | 2015-03-05 |
Last Update Date | 2024-03-22 |