NPI | 1891144374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002196) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN62564) |
Enumeration Date | 2016-06-06 |
Last Update Date | 2016-06-15 |