| NPI | 1437557949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: HI APRN-1834) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI APRN-1834) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: HI APRN-1834) | |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2015-02-09 |