NPI | 1487950705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN001260) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NV APRN001260) |
363L00000X Nurse Practitioner (Licence: NV APRN001260) | |
Enumeration Date | 2011-02-03 |
Last Update Date | 2021-12-07 |