NPI | 1710286331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI NPP37648) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2261011) |
Enumeration Date | 2011-03-22 |
Last Update Date | 2013-10-31 |