NPI | 1720384993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NV APRN001629) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV APRN001629) |
363LF0000X Nurse Practitioner, Family (Licence: CA 20309) | |
363LF0000X Nurse Practitioner, Family (Licence: NV APRN001629) | |
Enumeration Date | 2011-02-04 |
Last Update Date | 2022-08-16 |