NPI | 1891142410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202101276NP-PP) |
Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: NV APRN002179) |
Enumeration Date | 2016-05-24 |
Last Update Date | 2025-09-17 |