NPI | 1477266237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1018809) |
Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: TX 1018809) |
Enumeration Date | 2022-12-26 |
Last Update Date | 2023-02-19 |