NPI | 1841808789 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001785) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001785) |
Enumeration Date | 2020-07-16 |
Last Update Date | 2020-08-11 |