| NPI | 1851286819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN299943) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN299943) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN299943) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN299943) | |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-27 |