| NPI | 1477722866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APN001024) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: NV APN001024) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2019-03-04 |