| NPI | 1902217656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN001681) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NV APRN001681) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV APRN001681) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NV APRN001681) | |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2021-10-12 |