| NPI | 1871169664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DC R252235) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1062404) |
| 363LF0000X Nurse Practitioner, Family (Licence: DC RN1062404) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186113) | |
| 163W00000X Registered Nurse (Licence: DC RN1062404) | |
| 163W00000X Registered Nurse (Licence: MD R252235) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R252235) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2026-02-16 |