| NPI | 1427409523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61558063) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 801089) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP131588) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2024-07-02 |