NPI | 1427648070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 836273) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN86006) |
Enumeration Date | 2021-01-19 |
Last Update Date | 2023-11-07 |