NPI | 1619446515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 832892) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV 832892) |
3747P1801X Technician, Personal Care Attendant | |
106S00000X Behavior Technician | |
Enumeration Date | 2018-11-20 |
Last Update Date | 2024-06-22 |