| NPI | 1467092080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005353) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: FL APRN11005353) |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2023-02-07 |