NPI | 1427406750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9220197) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP 9220197) |
363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP 9220197) | |
Enumeration Date | 2016-05-26 |
Last Update Date | 2016-05-26 |