NPI | 1851322408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APN325) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 10625) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP1396252) | |
363LF0000X Nurse Practitioner, Family (Licence: CO 109713) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2007-07-08 |