| NPI | 1427769587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 080261-23) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 080261-23) |
| 363L00000X Nurse Practitioner (Licence: NH 080261-23) | |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2023-01-15 |