| NPI | 1770940827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: PA SP015846) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0011628) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP015846) | |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2021-05-25 |