NPI | 1982186144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.01022117-C-NP) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP60872393) |
Enumeration Date | 2018-09-04 |
Last Update Date | 2025-01-14 |