NPI | 1902321607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R83620) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OK R83620) |
Enumeration Date | 2017-08-03 |
Last Update Date | 2018-03-17 |