| NPI | 1437493277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA GAA-NP003042) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: TN 124027) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 33674) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2025-02-17 |