| NPI | 1528470655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: MN 368) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN623978) |
| 367A00000X Advanced Practice Midwife (Licence: PA MW010341) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2018-11-01 |