| NPI | 1457668618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9279002) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9279002) |
| 225700000X Massage Therapist (Licence: FL MA29917) | |
| 208D00000X General Practice (Licence: FL ARNP9279002) | |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9279002) | |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2024-05-23 |