| 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 |