| NPI | 1417289562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NH 087980-23) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NH 941) |
| Enumeration Date | 2010-01-31 |
| Last Update Date | 2024-10-29 |