NPI | 1457899296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA NP95005856) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI APRN-2218) |
363LA2200X Nurse Practitioner, Adult Health (Licence: CA NP95005856) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: HI APRN-2218) | |
163WG0600X Registered Nurse, Gerontology (Licence: CA RN95111445) | |
Enumeration Date | 2017-02-01 |
Last Update Date | 2023-03-07 |