| NPI | 1710420542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002361) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV APRN002361) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV APRN002361) | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2025-03-04 |