| NPI | 1548643588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014300) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60843709) |
| 363LF0000X Nurse Practitioner, Family (Licence: HI APRN1944) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60844577) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 288841) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0999054-NP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1076557) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2023-09-11 |