| NPI | 1427210061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1048921) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 5661479) | 
| 363L00000X Nurse Practitioner (Licence: NV 881818) | |
| 363L00000X Nurse Practitioner (Licence: MI 4704419881) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO C-RXN.0101849-C-NP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 55235) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 115600) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AR 230539) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71015744A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A181447) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 55235) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1048921) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 230539) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 115600) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71015744A) | |
| Enumeration Date | 2008-06-25 | 
| Last Update Date | 2024-11-07 |