NPI | 1386884377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-100169) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-100169) |
Enumeration Date | 2009-03-03 |
Last Update Date | 2021-02-03 |