NPI | 1891151148 |
---|---|
Former Name | STEFAN ALEXANDER DENNIS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 2004038) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 2004038) |
Enumeration Date | 2015-12-31 |
Last Update Date | 2016-06-04 |