| NPI | 1851052104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0012815) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1632413) |
| 163W00000X Registered Nurse (Licence: AZ 227134) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 227134) | |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2024-07-30 |