NPI | 1780324442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NV 8559879) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM 67636) |
363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1074020) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1074020) | |
Enumeration Date | 2022-03-30 |
Last Update Date | 2024-09-25 |