NPI | 1407349715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 812685) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: HI RN80851) |
363LF0000X Nurse Practitioner, Family (Licence: HI APRN-2456) | |
Enumeration Date | 2018-06-11 |
Last Update Date | 2024-03-19 |