NPI | 1497050306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP142679) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS R790626) |
Enumeration Date | 2011-01-24 |
Last Update Date | 2021-01-06 |