| NPI | 1861893414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 176B00000X Midwife (Licence: CA CNM236316) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201406326NP-PP) |
| 367A00000X Advanced Practice Midwife (Licence: NY F002184-01) | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2025-05-06 |