NPI | 1417443169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD R232767) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R232767) |
Enumeration Date | 2018-07-05 |
Last Update Date | 2024-04-29 |