| NPI | 1366957425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APRN002758) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NV APRN002758) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2021-10-21 |