NPI | 1740554732 |
---|---|
Former Name | ROBERT C ALLEN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC APN 17717) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11005398) |
Enumeration Date | 2012-03-08 |
Last Update Date | 2021-05-06 |