NPI | 1497339220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 272897) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN183690) |
Enumeration Date | 2021-05-07 |
Last Update Date | 2022-03-24 |