| NPI | 1487600896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN330264) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA RN330264) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-08-15 |