NPI | 1548669823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR AK3349289) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AR A004186) |
Enumeration Date | 2014-08-22 |
Last Update Date | 2024-06-07 |