NPI | 1417420019 |
---|---|
Former Name | JULIA K VINER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP019774) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP019774) |
Enumeration Date | 2019-01-07 |
Last Update Date | 2025-05-31 |