NPI | 1427092683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200950024NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00156444) |
363LF0000X Nurse Practitioner, Family (Licence: WA AP30007167) | |
Enumeration Date | 2006-06-16 |
Last Update Date | 2020-11-09 |