NPI | 1629074398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0106X Nurse Practitioner, Occupational Health (Licence: FL ARNP1344742) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP1344742) |
Enumeration Date | 2005-06-27 |
Last Update Date | 2025-09-11 |