NPI | 1437975554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11036368) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9384781) |
Enumeration Date | 2024-11-25 |
Last Update Date | 2024-11-25 |