NPI | 1962453043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 056047-23) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 236916) |
363L00000X Nurse Practitioner (Licence: NH 056047-23) | |
Enumeration Date | 2006-05-13 |
Last Update Date | 2025-01-14 |