| NPI | 1447312178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15996) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 568148) |
| Enumeration Date | 2006-12-16 |
| Last Update Date | 2024-11-12 |