NPI | 1760447437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 027125-23) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 027125-21) |
Enumeration Date | 2006-04-18 |
Last Update Date | 2017-01-10 |