| NPI | 1841726031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024033733) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MO 2011034027) |
| Enumeration Date | 2017-05-07 |
| Last Update Date | 2024-09-26 |