| NPI | 1497267587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APRN002868) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NV APRN002868) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2024-06-01 |