NPI | 1487178927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002579) |
Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: NV RN66219) |
Enumeration Date | 2017-07-26 |
Last Update Date | 2020-06-17 |