| 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 |