NPI | 1760826275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: DE LG0000677) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD AC001174) |
Enumeration Date | 2013-04-26 |
Last Update Date | 2021-08-31 |