NPI | 1801675178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14614-33) |
Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: IL 209027055) |
Enumeration Date | 2023-09-26 |
Last Update Date | 2023-10-10 |