NPI | 1902265945 |
---|---|
Former Name | ALON BRACHYA JACOBS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 340368) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340368) |
Enumeration Date | 2016-02-18 |
Last Update Date | 2019-03-22 |