| NPI | 1457144248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: NY 002426) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: CO CNM10128) |
| Enumeration Date | 2025-05-26 |
| Last Update Date | 2025-10-03 |