| NPI | 1700246972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9346616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-2831) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0001708-C-NP) | |
| 363L00000X Nurse Practitioner (Licence: NV 814181) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID CNP63808) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 57650) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 082291-23) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61035326) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 45491) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 158168) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 113107) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 7346) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC003115) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 202000545NP-PP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 158013) | |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2021-06-18 |