NPI | 1437185071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP30004883) |
Additional Taxonomies | 174400000X Specialist (Licence: WA AP30004883) |
Enumeration Date | 2006-06-24 |
Last Update Date | 2014-02-20 |