NPI | 1518300813 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014911) |
Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP013399) |
364SF0001X Clinical Nurse Specialist Family Health (Licence: PA SP014911) | |
Enumeration Date | 2013-04-17 |
Last Update Date | 2019-05-22 |