| NPI | 1811468432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11731) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: AZ Ap11731) |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: AZ AP11731) | |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2025-10-07 |