NPI | 1639717713 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903338) |
Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: MS 903338) |
163WH1000X Registered Nurse, Hospice (Licence: MS 903338) | |
163WI0500X Registered Nurse, Infusion Therapy (Licence: MS 903338) | |
163WN1003X Registered Nurse, Nutrition Support (Licence: MS 903338) | |
163WW0000X Registered Nurse, Wound Care (Licence: MS 903338) | |
163WX0200X Registered Nurse, Oncology (Licence: MS 903338) | |
207X00000X Orthopaedic Surgery (Licence: MS 903338) | |
207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MS 903338) | |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MS 903338) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 903338) | |
Enumeration Date | 2019-12-19 |
Last Update Date | 2019-12-19 |