NPI | 1427788348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9524250) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F06220224) |
Enumeration Date | 2022-06-14 |
Last Update Date | 2022-06-14 |