NPI | 1477126662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 844813) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV 844813) |
Enumeration Date | 2021-07-23 |
Last Update Date | 2024-05-16 |