| NPI | 1598243743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9350599) |
| Additional Taxonomies | 163WH0500X Registered Nurse, Hemodialysis (Licence: FL RN9350599) |
| 363L00000X Nurse Practitioner (Licence: FL F07180936) | |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2023-04-14 |