NPI | 1619798840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 818827) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NV 818827) |
Enumeration Date | 2024-10-21 |
Last Update Date | 2024-10-21 |