NPI | 1447581756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP003515B) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN269982L) |
Enumeration Date | 2010-01-26 |
Last Update Date | 2010-01-26 |