NPI | 1568259182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AR 216407) |
Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: OK 00) |
Enumeration Date | 2025-04-24 |
Last Update Date | 2025-04-24 |