| 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 |