NPI | 1427296771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 173000000X Legal Medicine (Licence: NJ 26NJ00172800) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ 26NJ00172800) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 29NJ001172800) | |
Enumeration Date | 2009-01-24 |
Last Update Date | 2016-08-12 |