NPI | 1942829643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LM-0000177) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: VA 0024178994) |
Enumeration Date | 2020-04-13 |
Last Update Date | 2020-05-26 |