| NPI | 1861092066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-4107) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-110794-0) |
| 163W00000X Registered Nurse (Licence: NY 711354-01) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: HI APRN-4107) | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2025-02-18 |