NPI | 1497285464 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 047822-23) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NH 047822-21) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2017-09-25 |