| NPI | 1467081000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 122653) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020021031) |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 53075) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 115034) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0101204-C-NP) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-03-27 |