| NPI | 1821334095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 821808) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NV 821808) |
| 163WH0200X Registered Nurse, Home Health (Licence: NV 821808) | |
| 111N00000X Chiropractor (Licence: CA 31503) | |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2024-09-05 |