NPI | 1447744735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11308) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN186001) |
Enumeration Date | 2018-06-19 |
Last Update Date | 2018-06-19 |