| NPI | 1891538385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 831347) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NV 831347) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2025-03-07 |