| NPI | 1740731777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9229519) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9229519) |
| 364SF0001X Clinical Nurse Specialist, Family Health (Licence: FL ARNP9229519) | |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2020-01-24 |