| 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 |