NPI | 1437783388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R208653) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R208653) |
163WH0200X Registered Nurse, Home Health (Licence: MD R208653) | |
Enumeration Date | 2020-03-01 |
Last Update Date | 2022-11-28 |