NPI | 1427409523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95029923) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61558063) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP131588) | |
163WG0000X Registered Nurse, General Practice (Licence: TX 801089) | |
Enumeration Date | 2016-06-29 |
Last Update Date | 2024-10-17 |