| NPI | 1396963005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: AZ TAP3666) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ TAP3666) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2010-05-27 |