NPI | 1447218326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209029418) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 74831) |
364S00000X Clinical Nurse Specialist (Licence: KS 53-74831) | |
Enumeration Date | 2006-05-02 |
Last Update Date | 2024-09-27 |