NPI | 1447696133 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6998855-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6998855-8900) |
Enumeration Date | 2013-05-21 |
Last Update Date | 2013-06-20 |