| NPI | 1437357217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 22244) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 22244) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2024-02-06 |