| NPI | 1568691905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: DE L1-0032177) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: PA RN590406) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP023631) | |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000702) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2023-05-01 |