| NPI | 1952545048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61168278) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP004163) |
| 111N00000X Chiropractor (Licence: WA CH60624911) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 358057) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL TPAN3527) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NV 894627) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95036572) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 39552) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ TELE329364) | |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2025-11-17 |