NPI | 1932686797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WA AP60892185) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: WA AP60892185) |
Enumeration Date | 2018-07-25 |
Last Update Date | 2020-12-02 |