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 |