| NPI | 1396550539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 322036) |
| Additional Taxonomies | 163WN0300X Registered Nurse, Nephrology (Licence: AZ 197505) |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2025-04-22 |