| NPI | 1861893414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: NY F002184-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201406326NP-PP) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2023-07-24 |