NPI | 1386695377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP130899) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP008998) |
Enumeration Date | 2006-05-13 |
Last Update Date | 2020-11-16 |