| NPI | 1609588433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 836957) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NV 836957) |
| Enumeration Date | 2022-12-26 |
| Last Update Date | 2023-01-11 |