NPI | 1881195048 |
---|---|
Other Name | GLENN EDWARD MOTT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 048276-23) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 048276-23) |
363LF0000X Nurse Practitioner, Family (Licence: NH 048276-23) | |
Enumeration Date | 2018-02-23 |
Last Update Date | 2023-07-24 |