NPI | 1437700234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020075) |
Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 209.020075) |
Enumeration Date | 2019-09-23 |
Last Update Date | 2019-10-31 |