NPI | 1508299348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1308A) |
Additional Taxonomies | 363LX0106X Nurse Practitioner, Occupational Health (Licence: ID NP-1308A) |
Enumeration Date | 2013-08-15 |
Last Update Date | 2013-08-15 |