NPI | 1528526332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F308844-1) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 308844-01) |
Enumeration Date | 2019-03-11 |
Last Update Date | 2022-07-22 |